More than half of adults over 65 take five or more medications daily. That’s not just common-it’s risky. Mixing pills, supplements, and over-the-counter drugs without checking for interactions can lead to falls, confusion, hospital stays, or worse. A medication review isn’t a routine checkup. It’s a safety check. Your doctor or pharmacist sits down with you to look at every single thing you’re taking-not just prescriptions, but vitamins, painkillers, herbal teas, and creams-and asks: Is this still helping? Is it safe?
This isn’t optional. Some clinics stop sending refills if you skip your review. Others limit your supply to a month until you show up. That’s how seriously they take this. The goal? Make sure you’re not taking something that’s doing more harm than good.
Don’t rely on memory. Write everything down. Or better yet, bring the actual bottles. A medication review isn’t complete without seeing what’s in your medicine cabinet.
Some people think, "I only take one pill for my blood pressure. Why bring the rest?" But if you’re on five meds and your doctor doesn’t know you’re also taking a sleep aid that makes you dizzy, they can’t fix the problem. Bring it all.
Just listing names isn’t enough. For each medication, include:
Use a notebook, your phone notes, or print a free template from your clinic’s website. The more complete this list is, the faster the review goes-and the better the advice you get.
What do you want out of this appointment? Be ready to say it.
Don’t wait for them to ask. If you’ve been feeling off, having trouble swallowing pills, or just feel overwhelmed, say so. Medication reviews are meant to be a conversation-not a lecture. The more you speak up, the more they can help.
They’ll ask you questions like:
Think about your answers ahead of time. If you’ve missed doses, admit it. If you’ve been skipping pills because they’re expensive or make you feel weird-tell them. They’ve heard it all. They’re not judging. They’re trying to fix it.
Ask them too:
If your review is over video or phone, you have one extra step: get your meds ready before the call.
Put everything you need on the table in front of you. Have your list open on your screen. Make sure your camera can show your pill bottles clearly. If you’re on a phone call, keep the bottles in your lap so you can hold them up when asked.
Test your tech beforehand. Download the app. Check your mic. Make sure you’re in a quiet place. If you’re having trouble hearing, say so. Don’t pretend you understood.
For people with Parkinson’s or other conditions that require precise timing, this step is even more critical. Missing a dose by 30 minutes can cause stiffness or tremors. Your pharmacist needs to see your schedule to spot gaps.
You won’t leave with a new prescription for everything. Often, the goal is to reduce what you’re taking.
Your provider might:
They’ll give you a written summary. Keep it. Show it to your family. Put it on your fridge. If you’re unsure about a change, call back before you stop or start anything.
Some clinics don’t wait. After sending three reminders, they’ll cut your prescription refills to a 30-day supply. After that? No more refills until you show up for your review.
This isn’t punishment. It’s protection. Without a review, doctors can’t know if your meds are still safe. They can’t tell if you’ve developed kidney problems, liver issues, or dangerous interactions. They’re not refusing care-they’re asking you to help keep yourself safe.
If you’re over 65, have diabetes, heart disease, or dementia, your review is even more important. You’re more likely to be on five or more drugs-and more likely to have side effects.
If you’re a caregiver, you’re the one who should go. Bring the patient’s meds, notes, and questions. If they can’t remember names or doses, you’re their voice.
Some clinics offer home visits if you can’t travel. Ask. Don’t assume you’re not eligible. You might be surprised.
Don’t wait for a letter. If you’re on five or more medications, schedule your review now. Call your doctor’s office or pharmacy. Ask: "When is my next medication review due?" If they don’t know, ask them to schedule one.
Start tonight. Gather your pills. Write down what they’re for. List any side effects. Bring it all next time. It takes 20 minutes. It could save your life.
Yes. Even if you stopped taking a pill weeks ago, bring the bottle. Your doctor needs to know what you’ve been prescribed and why you stopped. Sometimes, an old medication can still be affecting your body, or the reason you stopped might point to a bigger issue like an interaction with another drug.
You can try, but it’s risky. People often forget names, doses, or why they started a medication. A bottle has the exact name, strength, and instructions printed on it. Seeing it helps the pharmacist catch errors-like if you’re taking two different pills with the same active ingredient. Bringing the bottles cuts down on guesswork and makes the review safer.
Absolutely. One of the main goals of a medication review is to find safer, more affordable options. Pharmacists can suggest generics, patient assistance programs, or lower-cost alternatives. If cost is a problem, say so upfront. They’ve helped many people switch to medications that cost less than $5 a month.
Many reviews are done by clinical pharmacists, especially in clinics with pharmacist-led programs. Pharmacists are trained to spot drug interactions, side effects, and dosing issues. They can recommend changes, which your doctor will approve. In fact, pharmacist-led reviews often catch more problems than doctor-only visits.
At least once a year. But if you’ve recently changed medications, been hospitalized, started seeing a new specialist, or are on five or more drugs, you should have one every 6 months. If you’re feeling worse-not better-on your meds, don’t wait. Schedule it now.
That’s exactly why you’re there. Many people don’t know what their pills are for. Write down your confusion and bring it to the appointment. The provider will explain each one in simple terms and help you match the pill to its purpose. You don’t need to know it all beforehand.
Yes, and you should. Medication reviews can be overwhelming. Having someone else there helps you remember what was said, ask questions you forgot, and support you if you’re nervous. Some clinics even encourage it. Just let them know ahead of time.
Not always. Some changes happen immediately. Others need time to test safely. Your provider might say, "Let’s lower this dose for two weeks and see how you feel." Or they might say, "We’ll stop this one, but monitor you for a month." Don’t expect instant fixes. Safety comes before speed.
Yes. Medicare Part B covers medication reviews when done by a doctor or pharmacist as part of your routine care. There’s usually no extra cost. If you’re charged, ask if it’s a copay or if it’s being billed correctly. You’re entitled to this service.
You have the right to ask for more information or a second opinion. Say, "Can you explain why this change is better?" or "Can we try a different option?" Your care is a partnership. If you don’t feel heard, ask to speak with another provider. Your comfort and safety matter.
2 Responses
Bringing all your bottles-even the ones you stopped-is non-negotiable. I’ve seen patients forget they were on warfarin for three months, and it caused a dangerous interaction with a new antibiotic. Documentation saves lives.
Let’s be real-most people can’t even spell ‘pharmacokinetics,’ yet they think they know how their meds work. I’ve reviewed over 200 charts. Half the time, patients are taking two NSAIDs at once. It’s a miracle they’re still alive. And yes, I’ve seen St. John’s wort tank SSRIs. Twice. In one week.
You think ‘natural’ means safe? Garlic supplements thin your blood like aspirin. Ginkgo? Same. And don’t get me started on melatonin doses-some people take 10mg. That’s not sleep aid, that’s hallucinogen.
And if you’re on Medicare, don’t assume the pharmacy’s ‘free’ program isn’t a trap. Always ask for the formulary. Always. I’ve had patients pay $800 for a drug that had a $3 generic. I’m not judging-I’m just the guy who fixes your mistakes after you’ve been to three ERs.
And yes, your ‘harmless’ herbal tea? It’s probably CYP3A4 inhibiting your clopidogrel. You didn’t know that? Then you shouldn’t be self-prescribing. Bring the bottle. Read the label. Or don’t. But don’t blame the doctor when you’re in the ICU.
Also, telehealth? If your camera’s blurry and you can’t hold up the bottle, you’re wasting everyone’s time. I’ve had patients try to describe pills as ‘the blue one with the weird line.’ No. Just no.
And if you think your pharmacist is just a ‘drug dispenser,’ you’re wrong. They’re clinical pharmacists. They have doctorates. They’re trained to catch interactions you didn’t even know existed. Stop treating them like a vending machine.
And for the love of God, if you’re over 65 and on five meds, you don’t get to say ‘I’ll remember.’ You’re not 30 anymore. Write it down. Use an app. Put sticky notes on your mirror. Your brain is not a pharmacy.
And if you skip your review? They cut your script. That’s not cruelty. That’s liability. If you die from a drug interaction they didn’t know about? They get sued. You think they want that? No. They want you alive. So stop being lazy.
And yes, I’ve seen people take a pill for ‘memory’ that was actually for Parkinson’s. They didn’t even know. That’s why you bring the bottle. Not your ‘memory.’ The bottle.
And if you think your ‘natural’ supplement isn’t regulated? It’s not. FDA doesn’t review turmeric capsules. That’s why you need a professional. Not Google. Not your cousin who ‘read an article.’
And if you’re on Medicare, you’re entitled to this. No copay. No hidden fee. If they charge you, file a complaint. I’ve filed 17. All were upheld.
And if you’re a caregiver? Good. You’re the only one who knows what’s really happening. Your mom says she’s fine? She’s not. She’s confused because of the benzos. Bring the bottles. I’ll wait.
And if you think ‘I’ll just stop it if I feel weird’? That’s how you end up in a psych ward. You don’t titrate antihypertensives yourself. You don’t. Ever.
Bring. The. Bottles.